Disease

To understand the biblical records concerning illness it is necessary to think oneself back into a world that knew nothing of germs, bacteria, viruses, antisepsis, anesthesia, the circulation of the blood, or the precise difference among catalepsy, "clinical death, " coma, and "final death."

Something was known of anatomy from animal sacrifices; we read of heart, liver, kidneys, bowels, bones, sinews, flesh, and skin (with some hesitation over translation), but the function of each was not understood. Most references to human organs are metaphorical: The heart is the seat of the will, the bowels of compassion. Similarly, many of the terms used for diseases and infirmities are unknown, and translation is occasionally reduced to informed guessing.

It is helpful sometimes to suggest modern names for conditions whose description puzzles us. In Deuteronomy 28:22, "wasting disease" may well be tuberculosis; "fever" is likely to be the prevalent malaria; in the Greek version, the word chosen for "inflammation" means "ague, " possibly another form of malaria; and "scorching heat" could be almost any skin infection. The most common "pestilence" in the Middle East over the centuries was the virulent "bubonic plague, " its "tumors" being the swollen glands characteristic of the disease ( 2 Sam 24:15 ; the Greek translation of 1 Sam 5:6-12, ; and the Assyrian record of the story in 2 Kings 19:35, ; both mention rats, the usual carriers of this infection ).

Psalms 31:10-11, 38:5-11, and Zechariah 14:12 are said to describe one disfiguring form of smallpox. Second Chronicles 21:19 probably refers to dysentery, and the RSV so translates at ac 28:8. We would probably speak of Saul's manic-depressive insanity ( 1 Sam 16:14-23 ; 18:10-16 ; 19:9-10 ); of Nebuchadnezzar's "paranoia with (ox?) delusions" (see Daniel 4:16Daniel 4:25Daniel 4:33 ); and of the "apoplexy" of Nabal ( 1 Sam 25:37-38 ); and possibly also of Ananias and Sapphira ( Acts 5:5Acts 5:10 ).

The Shunammite's child apparently collapsed because of sunstroke, a common danger ( 2 Kings 4:18-20 ; Psalm 121:6 ). "Crippled from birth" ( Acts 3:2 ) suggests congenital club-foot; "she was bent over and could not straighten up at all" ( Luke 13:11 ) recalls the widespread curvature of the spine (tubercular, or osteoarthritic?).

Among skin diseases we may hesitantly recognize boils, eczema, and skin cancer; the details in 2 Chronicles 16:12-14 suggest gangrene. Leprosy was prevalent, and variously described as "blotches, " "scars, " "eruptions, " "whiteness, " "bright patches, " and "ulceration"; it had many forms, most of which can be only approximately identified in the Hebrew terms. Despite the ignorance about germs, the danger of contagion was realized and isolation enforced. Detailed religious rites of "purification" from leprosy's "uncleanness" were elaborated. Whether "true" (most virulent) leprosy is named in the Bible is much debated.

Nervous ailments are more difficult to recognize in the Bible's language. The paralysis of Mark 2:3 and the "shriveling" of Mark 3:1 were possibly of nervous origin, if not accidental. Much illness was attributed to "bile" ("gall, " Job 16:13 ), and Timothy's trouble, in view of his timidity, could well have been nervous dyspepsia ( 1 Tim 5:23 ).

Precision and certainty on the theme of disease are obviously rare, creating problems for translators. At Mark 9:17, 25, the RSV text speaks of spirit possession, the page-heading of "epilepsy"; at Matthew 17:15 the RSV uses "epileptic" for Matthew's "moonstruck"; at Matthew 4:24, epileptics are distinguished from demoniacs.

In general, neither climate, sanitation arrangements, water supply, nor prevailing ignorance, fostered good health in Bible lands. Infant mortality was high, and large families were in part compensated for it. Life expectancy is often asserted to have been short, despite the recorded ages of the patriarchs. But "sixty and ten" or "eighty" of Psalm 90:10 (even if amended to state life's "highest point") is not greatly different from our own life expectancy today. The gathering infirmities of old age are described in Ecclesiastes 12:1 with a sympathy and poetry rare in literature.

Lacking scientific explanations, Judaism had to seek other causes of the ubiquitous sickness. Disease had a religious dimension for all ancient peoples, partly from the natural recourse to superhuman help in danger or distress; idol shrines at Corinth, Ephesus, and Rome were as beset with sufferers as was the Jerusalem temple. Ill fortune of all kinds being inflicted by the gods, they alone could remove it.

For Jewish minds the underlying problem was especially acute. God created all things, and they were "very good." Whatever in human experience was not "good" was therefore alien to God's intention. Pain, sickness, and death must be due to self-willed interference by humankind with God's perfect plan. So Genesis 1-3 presents the most common Jewish theodicy: Sickness and distress are God's judgment on evil. Even the pains of childbirth are held to be a punishment for sin ( Gen 3:16 ; cf. Deut 28:15-68 ; 32:39 ). The code of punishments prescribed by the law for particular sins rests upon this evaluation, that the sinner should suffer.

Job's friends thus argued that his disease and suffering proved his sinfulness; the Pharisees argued likewise, as did Jesus' disciples ( John 9:2 ); and Paul so interprets the sickness prevalent at Corinth ( 1 Cor 11:27-30 ). Job, however, resolutely affirmed his innocence, and the lesson of the book is that suffering may be permitted to test and vindicate devotion. Paul, too, looked upon his "thorn" as a spiritual discipline and education ( 1 Cor 11:30 ).

Another modification of the assumed connection between sickness and sin accepted that others might be innocently involved. The sins of the fathers might be visited upon children unborn ( Exod 20:4 ), while social sins might bear most heavily upon one who bore the sins of others (Isa. 53). In this way, all are "bound securely in the bundle of the living" ( 1 Sam 25:29 ), although against this Ezekiel and others protested (ez 18 cf. Deut 24:16 ; Jer 31:29-30 ).

Jesus, too, very firmly rejected the theory that individual sickness and suffering were always due to individual sin, when the question was put to him concerning Pilate's cruelty to certain Galileans, and a falling tower that killed eighteen, and yet again in reply to his disciples ( Luke 13:1-5 ; John 9:3 ). Jesus met sickness and affliction with unfailing sympathy, never with condemnation, even when some connection with sin might be assumed. He did pronounce forgiveness for a paralytic before healing him ( Mark 2:5 ), possibly to remove from the sufferer's mind the obstacle, based on received doctrine, that healing could not begin until the sin that caused it was pardoned. Or he may have diagnosed that patient's spiritual condition as clearly as his physical need. So Jesus warned another healed man to "stop sinning, " that nothing worse befall him ( John 5:14 ).

The teachers of moral wisdom in Israel preferred to lay the blame for physical deterioration upon particular indulgences and excess. Overindulgence in wine is frequently condemned on health grounds; Proverbs 23:29-35 vividly describes the physical and mental effects of tarrying long over wine, especially mixed wines (cf. Isa 28:7-8 ). Ben Sirach adds a strong warning, again on health grounds, against gluttony, and urges the therapeutic value of "industrious work" (margin: "moderate work" ). He inculcates a wise self-understanding in diet, and avoidance of any mere habit of luxury and gluttony (Sirach 31:19-22; 37:27-31). Somewhat unexpectedly, Job blames unhealthy attitudes of mind for destroying those who know no better, "vexation" ("resentment" NIV), "jealousy" ("envy" NIV, Job 5:2 ; cf. cheerfulness, despondency, sorrow, Prov 15:13 ; 17:22 ). A psalmist teaches those who desire long life and "many good days" to keep from speaking evil and falseness, to depart from evil and practice good, and diligently to pursue peace in all situationsa clean mind, unburdened conscience, and peaceable spirit, making for healthy living ( Psalm 34:11-14, ; quoted in 1 Peter 3:10-12 ).

Later, another dimension of the cause of disease and affliction was added to those of theologians and moralists: the idea of a world infested with living spirits, some benign but most malignant. In Israelite thought, some spirits, although working to hinder and deceive humans, were nevertheless messengers of God ( Judges 9:23 ; 1 Sam 16:14 note contrast with "the Spirit of the Lord" 1 Kings 22:20-23 ). Such spirits, although evil, were under divine control.

New Testament belief in evil spirits ("demons") under the direction of a supreme devil was almost universal. To them were attributed disorders of all sorts, whether moral, mental, or physical. All were believed to be under the ultimate control of God, but he permitted their activity when sin gave them entrance, to punish sinfulness in humankind.

According to the Synoptic Gospels (John does not mention demons or exorcisms) Jesus dealt commandingly with sickness and affliction, firmly demanding the spirits be silent and leave the tormented. Luke, a physician, delights to show that Christ had overcome Satan, binding "the strong one" and spoiling his possessions. Jesus watched Satan fall from above, and by superior power delivered those whom demons had bound or afflicted ( John 4:1-13John 4:36John 4:41 ; 6:18 ; John 8:2John 8:26-35 ; 10:18 ; 11:15-26 ; 13:16 ).

The prevalence of disease and suffering in the ancient world inevitably influenced religious and ethical language. Isaiah describes the sad social and moral condition of Judah: "From the sole of your foot to the top of your head there is no soundness" (1:6). His terms hover between medical descriptions and metaphors for moral sickness, as do those of Psalm 38. And this use of medical metaphors for spiritual and moral "sickliness" or "infirmity" continues into the New Testament in phrases like "the body is weak" ( Matt 26:41 ), "weak in conscience" ( 1 Cor 8:7-12 ), "weak in faith" ( Rom 14:1-2 ; 15:1 ) and (morally) "powerless" ( Rom 5:6 ).

A similar association of ideas shaped Jesus' defense of his friendship with sinners as resembling the concern of the physician with the sick ( Matt 9:11-12 ). Jesus does not say the sinner is "sick, " which might imply that sinfulness is misfortune rather than fault. But the parallel he draws lends some authority to the compassion of those who see the sinful as victims of their own folly or viciousness, and i need of help and understanding.

There is a moral blindness, deafness, shortsightedness, madness, paralysis, weakness, "seizure, " as deadly as the physical counterpart. It was easy to state the gospel of salvation in terms borrowed from unhappy experience of disease and afflictionas Jesus did at Nazareth ( Luke 4:16-21 )and be sure of being understood. The thought is carried further in the "soundness, " "healthiness" of true doctrine, teaching, words, faith, and speech, referred to nine times in the Pastoral Epistles, as appealing to, and promoting, sane, safe religion.